Lessons from Levi

My foster dog Levi and I spend a lot of time together. Since I work from home, he’s constantly curled up next to me, usually sleeping while I’m working. They say that owners and their pets sometimes start to resemble one another over time. I’d definitely say that’s been true of Levi and I.

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There’s a lot we can learn from our pets. In fact, I found a great list on Huffington Post of what dogs can teach us about what matters most. They remind us to live in the moment, to not hold grudges, to be loyal and dependable, and to love unconditionally.

Yesterday though, I found myself imitating Levi in a completely different way.

It was after my bootcamp class. My blood sugar was on the rise, but this was to be expected since this particular fitness class always seems to raise my blood sugar an hour later. Anticipating this rise, I had given a few units of insulin once class ended. I ate dinner, giving another bolus. But it was as if I was delivering water instead of insulin, it wasn’t doing anything to stop my rapidly rising blood sugar! By 9:30 pm I found myself staring at a staggeringly high number, the highest I’ve seen in a very very long time. I changed my infusion set and gave a correction through an injection.

At this point in the night, I was feeling truly miserable. I was thirsty, nauseous, my body and head ached, my brain felt foggy. But it was the end of the night and I had to take Levi out before bed.

LeviDance.gifThat’s when I realized that Levi was doing exactly what I needed to be doing! Tonight, I would channel my inner dog and follow Levi’s example.

Excited to be outside, Levi started pulling me to walk faster. Alright I got it, we’ll pick up the pace! Exercise, including walking, can be beneficial in lowering blood sugar. Great thinking, Levi.

While on our walk, Levi kept stopping to sniff and pee every 10 feet. While stopping so often on a walk is annoying, frequent urination to flush out your system is important when dealing with high blood sugars or even small amounts of ketones. Smart thinking again, Levi.LeviDrink.gif

When Levi finally finished emptying his bladder and marking every pole we passed, we went back inside. Levi made a dash straight for his water dish, lapping up the entire bowl. Drinking lots of water! This can help the kidneys flush out the extra glucose in the blood. Great and important advice, Levi!

I checked my blood sugar again, finally it was coming down! The rapidly dropping arrows confirmed that I was trending in the right direction and I was starting to feel a little bit better.

With the worst behind me, I followed Levi’s lead one last time that night.

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By 12:30 am, my blood sugar was back to normal. Thanks for all the lessons, Levi!

 

Balancing bouquets and blood sugar

You know that feeling you get when you forget your phone? It’s that uncomfortable, anxious, itch that leaves you feeling like a little piece of you is missing. Well this past weekend, I experienced a similar feeling, but it wasn’t my phone that I was without, it was my all my diabetes supplies.

This past weekend was my first experience being a bridesmaid in my friends’ wedding. What an incredible experience it was! The wedding was so beautiful and I was honored to be a part of it. But one piece I did have to think and plan ahead of time was what I would do in the event that my blood sugar dropped low during the ceremony. You see, the 20-30 minute ceremony was the only part of the night where I wouldn’t have immediate access to my purse and thus my meter, CGM, and fruit snacks. I had no pockets or place that I could easily access to put my fruit snacks. And it’s not that I haven’t gone that amount of time being away from my supplies, it was more the fact that I would be standing in front of a crowded room of people, lined up among the bridesmaids. Granted, everyone would be looking at the bride and groom and not me if I did have to step away and treat a low, but I really didn’t want to cause any type of disruption or set myself apart from the rest of the bridal party. I wanted it to be perfect for my friends.

imageBut part of having type 1 diabetes is always being prepared for an emergency and always putting your health first. So I was determined to come up with a solution.  My plan was to keep my blood sugar a little elevated during the ceremony, just to be safe. However that did not work as planned. Instead, I was fighting sky high blood sugars all during the day, so there was a very real possibility that it could crash during the ceremony, despite my best efforts. I thought about hiding the fruit snacks in my bouquet, but the beautiful arrangement wasn’t able to adequately conceal them. The final solution: I took a plastic baggie and dumped the pack of fruit snacks in it. I knew the plastic bag would be less crinkly than the wrapper. Then I folded down the edges of the bag so I could easily reach in for a gummy. Finally, I scrunched the bag as small as I could and held it in my hand, hidden within my grip on my bouquet of flowers. You couldn’t see them, but I felt secure knowing my fruit snacks were with me if worse came to worse. After all, it’s probably better to sneak a fruit snack during the ceremony than to pass out from low blood sugar  ;-).

Luckily I did not need my fruit snacks and the ceremony went perfectly. They don’t tell you when you’re diagnosed that you’re going to end up doing a lot of creative problem solving to make your diabetes fit your life. But not matter the situation, diabetes may be an extra consideration, but it will never stop you from living the life you want.

A scary situation (told using bitmojis)

I recently found myself in a very scary situation as a diabetic. Let’s just say that I was about to drive myself to the hospital for my blood sugars, which I’ve never had to do before. Spoiler alert: I didn’t and everything is fine now, but it was still a frustrating and slightly alarming afternoon.

It started at my company picnic. It was a beautiful spring day and I was happy to be outside with my coworkers.

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But my blood sugar was high and rising fast.

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I had bolused for my lunch and figured it would eventually come back down. I was away from my CGM playing frisbee, running to catch it, and figured the activity would probably help lower it too.

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Not a frisbee, but closest I could find

After playing for close to an hour, I checked my CGM, but instead of my blood sugar going down, it was still going up.

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I corrected for the high giving more insulin and headed back inside to the office. My CGM started to point downward and I figured I was in the clear.

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As soon as I got back to my office, I went straight into a meeting. I sat there trying to pay attention to what was being said, but I was starting to feel nauseous and out of it. I felt so sick, I knew something had to be wrong.

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Luckily the meeting was short and I immediately checked my blood sugar number again, this time it had risen to over 500! I was shocked!

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I texted my dad and my sister (who is a nurse and soon to be a nurse practitioner) and filled them in. Then I rushed to the bathroom and gave myself a shot and changed my infusion set.

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I went and told my manager that I had to leave work early. I decided that if in one hour, my blood sugar wasn’t clearly going down, I would drive myself to the hospital. If all the insulin I had been giving wasn’t working, I knew I needed to get help.

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I got home and checked my ketones, which looked fine. Then I got a large glass of water and laid down on the couch, praying that my blood sugar would start to drop. About a half an hour later, I started to get some good news. And as it continued to fall, I gave my dad and sister a play-by-play.

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I was slightly bummed that I was missing my weekly bootcamp workout class, but I was just so relieved that my blood sugar was coming down. And as it dropped, I started to feel better physically too.

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I continued to lay on the couch, taking it easy as I watched my blood sugar fall. Soon it was dropping double arrows fast.  I started to worry that I may have given too much insulin and I was going to crash, which has happened many times before. I just wasn’t in the mood to be caught on a roller coaster of highs and lows.

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But finally, after about a total of 3 hours later, my blood sugar was almost completely back to normal and I could finally relax.

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So everything was fine and life went on, but it definitely was an experience that I hope never happens again!

Can I have a re-do?

I often dread my endocrinologist appointments. But at the same time, I’m thankful for the 4 appointments each year. They’re forced moments of reflection, confrontation, and adjustment. Before each appointment, I consider how things are going. I know if the past 3 months have been good or bad. If it hasn’t been a good 3 months, it’s a time to confront myself and delve into why my numbers have been high or low or just all over the place. Sometimes it’s my own self-management habits that have slipped, other times it’s factors that are out of my control like getting sick. Then based on how things are going, I make adjustments along with my doctor and move forward.

Today was one of those appointments that I just wanted to get over with. The past month and a half has been rough. My numbers have been running high consistently. Between getting a pretty horrible cold that lingered, having to go on steroids for the sickness, stress from a breakup, adjusting to time changes of traveling, and then just a weird couple weeks where it seemed like my insulin wasn’t working as it normally does, I knew my doctor would be looking at some pretty awful numbers at our appointment.

Part of me is disappointed. I don’t like to be this off track. I don’t like knowing that I’m potentially doing lasting damage to my body, that I’m increasing my risk of complications. But I also know that life happens. There’s a lot that I can’t control and those events may unfortunately impact my health by way of my blood sugar. All I can do is my best to try to manage the consequences.

Diabetes is a chronic disease. It means that as of right now, I’m stuck with it for the long haul, it’s not going anywhere. And as much as I get caught up in these mini 3 month sprints between appointments, there’s a bigger picture. Three months is not very long when you look at a lifetime. And shit happens. There will be highs and lows in life just as there are in my blood sugar. I admit, I’ve had other things on my mind lately besides my diabetes and I’m sure that’s played a part. But I can’t control everything that happens, at some some point you have to let go and just do the best you can within your circumstances.

So yea, I’m not thrilled about this appointment and the past few months. But unfortunately there’s no re-do’s or rewinds with a chronic condition. What’s done is done. Now, I’m putting aside my excuses and focusing on moving forward.

 

A day in the life

Some days I’m surprised I get anything done with how preoccupied I am thinking about my blood sugar.

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Explanations

I’ve learned over the years that I’m someone that craves explanations. I want things to make sense, I want to know why something may have happened. I need logic.
Granted, I don’t always need to know exactly why something happened, sometimes we just don’t know, but I find myself still wanting to make an educated guess. And when there is a disconnect between what happens and a proposed explanation, I get frustrated. “That’s impossible! There’s no way that what you just said could have caused that.” Those close to me are all too familiar with my need for logical conclusions, and my irritated response when I’m not satisfied with the answer.
But I know we don’t always get answers. Why do bad things happen to good people? Life is random, mysterious, and unpredictable at times, it’s part of what makes it both devastating and exhilarating. In many cases I’m perfectly content with the explanation that sometimes things happen that there are no logical explanations for, it’s the universe at work.

My diabetes falls somewhere in the middle.

Too many times I’ve found myself frustrated with a high or low blood sugar, not understanding why it happened when it seemed that I did everything “right” to avoid it. I rack my brain trying to come up with a logical explanation, but sometimes there are just too many variables to consider. Was I really that far off in my carb counting? Is this a delayed effect from the exercise I did earlier? Is something wrong with the insulin? Is there a bend in the tubing? Is the insulin not being absorbed at the site? Am I getting sick? Am I stressed? So much to consider, I can’t always draw a one-to-one connection for a high or low.

Last week I was shocked to see a blood sugar that was over 500. A rare event, my first thought was why?? Well really it was “Oh f*ck” but then why did this happen?!? I ran through the list in my head as I tested my ketones, gave myself a shot, and changed my infusion set.

You don’t always get answers for everything in life. I’ve learned to accept it and move on with the information that is available.

But sometimes, when you’re lucky, you get exactly the explanation you need.

bent infusion set cannula blocking insulin from being delivered

The Missed Meeting

It was 10:28.

I was late. I was never late.

Every day at 10:15 we have a “stand up” at work, a quick standing meeting, sometimes just 15 minutes long, that I haven’t missed…until today.

10:28. How did I miss it? Oh yea, I remember.

Gigi had been acting up all morning, never really connecting and so not graphing my blood sugars. I had started the morning within my normal range, but at the higher end. But I was starting to feel pretty sick. With no help from Gigi, I tested my finger. 437! Shiiiiiiiiit.

I wasn’t sure how that had happened.. I went to the bathroom and first changed my set. It was close to being empty and I didn’t want to take any chances. Then I gave myself a shot. Since I don’t normally use syringes at work, I wondered if my workplace had a sharps container.

I walked to our front desk to inquire. “Do we happen to have a sharps disposal here?”

My question was returned with perplexing looks. “Like for…sharp…things?”

“Yea like needles.” Then I quickly added, “for insulin shots,” not wanting there to be any misunderstanding.

“No we don’t have one. But we can look into getting one.”

“Oh, it’s not a big deal, I can take it back home, I was just wondering.”

I started to walk away when the office manager stopped me. “Hey, one more thing. We are working on our emergency preparedness plan for the office. We are going to get cases of water, would orange juice be something that you would want us to get too?”

For some reason this question caught me by surprise. For as long as I can remember, I’ve always had to be prepared. I look out for myself, never knowing when a low blood sugar might strike. I guess I wasn’t expecting that my office would want to be prepared for me specifically as well. I thought back to a few months ago when we were all stuck in the basement for 3 hours during a tornado warning. I had a few packs of fruit snacks with me, but I did worry if I ran out. It would be reassuring knowing there would be an office emergency stash.

“Um actually yea, that would be great. Orange juice is perfect for low blood sugars. Thank you!”

“We’ll be sure to pick up some and look into the sharps container.”

I thanked her and walked away, glad that I work for a company that is so understanding and accommodating. I walked back to my desk, checked my blood sugar again, and looked at my clock.

10:28. Crap. I quickly emailed my coworker, apologizing for missing the meeting and explaining that I had some diabetes issues to take care of and lost track of time. It wasn’t a lie, but at the same time I try never let my diabetes be my excuse and didn’t like using it this time. I know my diabetes is disruptive. It wakes me in the middle of the night, it stops me in the middle of my workouts, it makes me rearrange my plans. But now it had gotten in the way of my work and made me miss a meeting. I was upset at myself for losing tack of time, even if I was taking care of my health, and hoped my coworker would understand.

Thankfully I had nothing to worry about. My coworker was more concerned with my health and wellbeing than with the fact that I missed the meeting. With my blood sugar on its way down, I hoped that the worst of the day was over.

I have to say how glad I am that I work in a place and with people that are so understanding of my health condition, I know that I’m lucky. And I know diabetes isn’t the only health condition that can get in the way of people’s productivity, everything from headaches and migraines to chronic pain, allergies, and stomach issues can be just as disruptive. But I hope that this was the last time that I’ll use my diabetes as an excuse and the last meeting I’ll miss because of it.

Oh the Irony

I have this ritual. Almost every time that I go for a long grocery shopping trip, I treat myself to a cold bottle of diet A&W root beer on my way out. I don’t drink a ton of pop and root beer has always been one of my favorites. Having performed this ritual enough times, I’ve come to recognize the diet bottle just from the color of it. I was finishing up a particularly epic grocery shopping trip and grabbed the A&W from the cooler as I got in line to pay, confident that it was the right one.

Parched from my long shopping excursion, I got into my car and immediately cracked open the pop and starting chugging, relishing the cool and refreshing taste. With half the bottle gone, I glanced down at the bottle. Something was off. I didn’t see the “Diet” sign anywhere! Shit.

Two thoughts immediately crossed my mind. Well technically first I silently cursed myself. But then my first thought was “What a waste of calories!!” followed by, “Holy crap that’s a lot of sugar!” A bottle of regular A&W root beer is a whopping 80 carbs! And here I had just drank close to half.

I took out my insulin pump and immediately started figuring out how much insulin to give. It looked like I drank half, but the top half of the bottle is skinnier than the bottom half, so maybe its not actually 40 carbs. I decided to subtract some to account for bottle shape and gave myself some insulin.

Within 5 minutes Gigi (my CGM) was already buzzing, displaying the two upward arrows showing that my blood sugar was rising quickly. I cursed again. Maybe I should give a little more insulin. I could just picture my blood sugar rocketing to the 300’s. I was pissed. What a stupid, careless mistake. Really I was thinking that if I was going to have that many calories and sugar, I would have preferred ice cream or at least a root beer float!

I went about my afternoon and tried to put the incident behind me. That is until about an hour and a half later.

Something wasn’t right. Gigi was being quiet, but all of the sudden I did not feel well. I got out my glucose meter and tested my finger. 37. Ummm what?! The low caught me off guard, as I was sure that I had given the appropriate amount of insulin according to the label. I needed sugar, and fast.

The bottle that only an hour earlier I was cursing, was now my salvation.

Ohhh the irony.

A1c Accuracy

“So how have you been?”

A seemingly innocent question asked by my endo as she sat down across from me. I never know quite how to answer this. I’ve been good. Really I have. My new job is going well, I’m enjoying living on my own in my new apartment, my weekends have been filled with fun events with my friends. I’ve been trying to get back into working out, I’ve been getting better at cooking and trying new healthy foods, things are good. But that’s not really what she wanted to know.

“I’ve been good.”

“How have your blood sugars been?”

Ah now we get to the real question.

Have they been high, low, are you having any problems, do you notice any patterns?”

“Shouldn’t you know?” I thought, assuming that she had at least looked at my graphs and A1c (which in fact she hadn’t since they were still being downloaded).

“They’ve been high lately, higher than I want, but I haven’t really noticed any patterns.”

“What about lows?”

“Yea I have them after the highs, probably from over correcting. Lots of roller coasters.”

We talked a little and made some adjustments and she got ready to wrap up the appointment.

“I was just wondering, what’s my A1c?”

“Oh I hadn’t even looked yet. (Ummm what, why not?”) It’s actually pretty good, 6.9.”

“Seriously? Are you sure?? That doesn’t make sense.” My doctor turned the screen so I could see it on the computer. I looked at her perplexed. “I’m shocked, are you sure that’s right?” It’s not that I didn’t believe that it could happen, after all almost exactly a year ago I was at 6.7, but I know what my blood sugars looked like then and I knew how they have been the past couple months, and something just wasn’t adding up. But I was hoping that maybe I was wrong. Maybe I was just remembering the worst of the past few months and in general I was doing pretty well. “I want a re-check,” I joked.

Yea I’m pretty surprised too, that doesn’t really make sense based on these graphs.”

I’m not going to lie, I kind of wanted my doctor to prove me wrong, to not agree with me. To point to some trend or something that showed that I wasn’t as off as I thought.

“We’ll have them test it again.”

In the 13 years that I’ve had diabetes and the over 50 A1c checks that I’ve had, I never really had a reason to doubt the accuracy of the test. But here I was, getting my first recheck. As I sat there waiting for the nurse to come back with the results I debated in my head whether it was better to be right or wrong in this situation. Right in that ordering another test was the correct decision, that the first result wasn’t accurate and that I know my numbers and my body. On the other hand, I was hoping that I was wrong. That I was doing better than I was giving myself credit for, that maybe my A1c was 6.9, a number I’ve been working to get back to.

The nurse walked in and I looked up expectantly.

“It’s 7.3.”

“Yea that makes more sense.”

Slightly disappointed that I wasn’t 6.9, I was still okay with that number. It’s been where I’ve been stuck at for the past 9 months so at least I wasn’t doing any worse. Okay, 7.3. it’s not my best, but it’s not my worst. I said the number over and over in my head…and then I let it go. I’m trying to use my numbers to guide me, but not get caught up in them. So instead, I thought about what I need to do different between now and my next appointment in 3 months. Rather than focus on the number itself, I thought about what I can do so that the next time I see that 6.9, I won’t doubt its accuracy.


Diabetes Blog Week- Day 2



“This year, Diabetes Blog Week and TuDiabetes are teaming up to bring out the poet in you! Write a poem, rhyme, ballad, haiku, or any other form of poetry about diabetes.”

CGM, Go To Bed

An ode to my continuous glucose monitor


10:30 pm:

I put you on my nightstand, I lay you down to rest,
In case I don’t feel well, my blood sugar you will test.

My blood sugar is steady, not too high and not too low,
That ice cream after dinner, I hope you will not show.

An undisturbed night of sleep is what I really need,
A steady line on your graph in the morning, I truly hope to read.

Slumber is upon me, I’m drifting off to sleep,
I beg you CGM, a quiet night without a peep.

1 am: Buzz buzz buzz

Double arrows pointing up I awaken with a start to find,
Of all the arrows, up and down, you’re my least favorite kind.

Not much I can do, laying here with insulin on its way,
Groggily back to sleep I go, and hoping this time to stay.

2 am: Buzz buzz buzz

My eyes spring open, you caught me quite off guard,
My bg’s now over 180, you just had to make this hard.

My number is too high now, but I’m hoping not for long,
It may start to drop too fast, but hopefully I’m wrong.

4:30 am: Beeeeeep Beeeeep Beeeeeep

From my nightstand I hear your sound, which can only mean one thing,
“You’ve dropped below 55, wake up, wake up!” your beeps eagerly sing.

I take my fruit snacks and into my mouth I dump them all,
For the last time tonight, please back to sleep I hope I fall.

4:45 am: Buzz buzz buzz

Now you say I’m under 80, well at least I’m on the rise,
Maybe giving insulin for that high wasn’t all too wise.

Please CGM, let this be all, I’m really very sleepy,
If you wake me up one more time I may get a little weepy!

7:30 Ringgg Ringgg Ringgg

You’ve got to be kidding me, what is it now? You haven’t had enough?
With all the ups and downs this night, my sleep has been quite rough.

It’s my alarm! Time to get up; to work I must get ready and go.
Oh what’s that on the graph? A perfect number NOW you decide to show!